Can a web tool help steer pain sufferers away from opioids?

It seems like every day a new online app or web-based tool is introduced to the world, and more applications for the modern tools are being found in the healthcare arena. Nurse researchers will be studying whether one such tool can actually help curb patients’ use of opioids for chronic pain and the shocking opioid addiction rates.

Marian Wilson, PhD, an assistant professor at the Washington State University College of Nursing, is joining a team of scientists who’ll lead a $2.5 million study that will investigate whether an online pain management program can help patients with chronic pain reduce or eliminate the amount of prescription opioids they take, according to a news release.

Wilson is a co-investigator on the EMPOWER study with lead investigator Theresa Winhusen, director of the Addiction Sciences Division in the University of Cincinnati College of Medicine. The five-year study will involve 400 non-cancer patients who are being treated for chronic pain with long-term opioid therapy at University of Cincinnati Health and Duke Health.

A web-based pain management tool, called Goalistics Chronic Pain Management Program, has been found in small previous trials to decrease patients’ pain and reduce opioid use. The study will expand the sample size, and researchers will have access to patients’ clinical records to accurately measure opioid use.
According to the Goalistics website, the program uses a variety of electronic tools to provide a foundation for learning. These tools include DVDs, online assessments, interactive learning, electronic messaging, in-stream video, online discussion forums and online data tracking and graphing. Features such as self-assessment, homework exercises and self-monitoring can be created to suit the specific goals of a program.

Opioid alternative

The EMPOWER study hopes to give primary care providers another method to use in helping patients manage chronic pain, while also responding to soaring opioid addiction rates and overdose deaths. The Centers for Disease Control and Prevention has recommended decreasing the use of opioids for treating pain.

According to CDC Guideline for Prescribing Opioids for Chronic Pain, an estimated 20% of patients presenting to physician offices with non-cancer pain symptoms or pain-related diagnoses (including acute and chronic pain) receive an opioid prescription. In 2012, healthcare providers wrote 259 million prescriptions for opioid pain medication, enough for every adult in the United States to have a bottle of pills.

“It’s a really difficult situation telling people, ‘Sorry, you can’t have your opioids, but we’re not really giving you an alternative,’” Wilson said in the news release. An online pain management program could be “a lifeline extended to patients, another tool to help manage pain. It’s something that can give them some hope and show that people understand what they’re going through.”

The research is being funded by the National Institute on Drug Abuse, part of the National Institutes of Health. Wilson said she’ll function as the study’s pain and online-program expert, while Winhusen, the lead investigator, will oversee the clinical trial.

Courses Related to ‘Pain Management’

60227: Interprofessional Guide to Pain Management (6 contact hrs)
Pain is experienced by almost all patients regardless of age or sex. Virtually all health professionals help patients who are experiencing pain, and physicians, nurses, therapists, psychologists, pharmacists and social workers can specialize in pain management. Thus, no single discipline completely understands pain, and how or why it manifests in individual patients. To provide comprehensive team-based care, professionals must understand the limits of their own expertise, while gaining insight from and an appreciation for that of other disciplines. This requires health professionals to collaborate to better assess, understand and manage patients with complex pain. By working together for the common goal of developing an effective, safe, comprehensive patient-centered treatment plan, patients with pain who don’t respond to usual treatments can have more positive outcomes.

CE442: Knocking Out Pain Safely with PCA (4.00 contact hrs)
For many postoperative patients, patient-controlled analgesia is the primary source for managing pain. The basic design of PCA includes a computerized pump that can deliver several medications, such as morphine, hydromorphone or fentanyl, according to an order written by a physician, nurse practitioner or physician assistant. Prescribers’ orders should clearly define the medication, dose, dosing interval, monitoring parameters, the one- or four-hour lockout total and the maximum dose of medication the patient can use in those time periods. PCA is not without risks. Nurses who understand the risks of PCA therapy will take all measures needed to ensure that patients are protected from PCA errors and receive excellent pain control. This module will discuss the use, benefits and risks of PCA and nurses’ responsibilities in caring for patients using PCA.

CE702: Responsible Opioid Prescribing, Chronic Pain and Addiction (1.5 contact hrs)
The increased emphasis on management of pain to improve quality of life and functionality of people with chronic pain has contributed to a significant increase in the number of opioid prescriptions being written. With increased availability of prescription pain medicine, there has been an increased risk of misuse and abuse. This educational activity will address issues related to the regulation, medical management, misuse, abuse and diversion of controlled substances.

About the author

Sallie Jimenez is content manager for healthcare for Nurse.com published by OnCourse Learning. She develops and edits content for the Nurse.com blog, which covers industry news and trends in the nursing profession and healthcare. She also develops content for the Nurse.com Digital Editions. She has more than 22 years of healthcare journalism, content marketing and editing experience.

I have syringomyelea…cysts along the spinal cord…I have had this condition diagnosed for 17 years. My most recent MRI ( August 29,2017 ) showed a cyst starting at approx C5 extending through T10. There is probably another cyst in the Lumbar region not visible in the current MRI. Luckily for me the MRI taken in August 2016 showed the very same cyst, size and shape.
I currently have numbness on my entire right side…I am developing some symptoms on the left side but not as dramatic.

I have been treated with Neurotin 1400mg q8h, Methadone 20mg q8h, Morphine Sulfate ER 100mg Q8h for the past 10 years. Although I have some break through pain on heavily rainy days, or times when it has rained for a week straight. I have been controlled with this mixture of drugs after several trial and error combinations, so I am comfortable. I realize this is a high dosage of medications, but this amount has come about over several years of trials. I am 72, and my husband is 83…we live alone with our rescue dog-Abby. ( no small children in the house )We have 6 children, and 10 grandchildren, the youngest being a junior in HS.

After all that background my comment: Hearing that the CDC is going to regulate how much medication my pain doctor can prescribe for me by the CDC’s rules and regulations SCARES ME TO DEATH. The thought of having pain because someone at the CDC thinks I have to large a dose of medications, should come to my house and listen to me moan and walk in circles until the pain tapers off. This is what I did until this level of medication was regulated.

How can the CDC judge everyone the same? I feel I have a pretty high tolerance for pain, but sometimes I cannot hardly stand the pain ! I feel sorry for people who abuse medications that then causes me to be suspected of doing the same thing. I take my pills by the clock and would never share or sell my medication cause I WANT the pills. I don’t get high or euphoric from my pills, they just relieve my pain.

Lynn, I just found this article and your reply. I am a nurse for over 30 years and the last of those years as a hospice nurse. I am sorry that you have a disease process that causes you so much pain and discomfort. I don’t think iy is the intent of the CC to take away your medication. They are trying to find a way to begin to curb the flow of drugs that end up on the street. I can not tell you how many patients I have seen over my career who had family members take the prescribed medications from a patient to either sell or feed their addiction. Much of the drugs on the street have come from medications that were prescribed and meant to help a patient.

My daughter had triplets 4 years ago and the doctor gave her oxycodone for pain after her C section and then she had to have a rotator cuff repair less than a year later with more oxycodone prescribed and she became addicted. Once she admitted to her addiction we found out she had been buying pills from someone on the street who was getting pills taken from the homes of elderly patients. Not everyone who is on medication for chronic pain is careful with keeping control of those medications and this is only one part of the drug crises in our nation.

I wish you well and I can only hope and pray that good people who truly need medication for their chronic pain do not have to suffer as a result of those people who abuse the medications.